van Harten P N, Matroos G E, Van Os J
Symfora Group Psychiatric Center, Amersfoort, The Netherlands.
Schizophr Res. 2008 Jan;98(1-3):79-83. doi: 10.1016/j.schres.2007.09.010. Epub 2007 Oct 23.
Tardive dystonia (TDt) is a severe side effect of long-term use of antipsychotics. Previous publications suggested that TDt persist but the results are distorted by referral bias. In a population-based nine-year follow-up study (one baseline, six follow-ups) of chronic psychiatric patients (N=194) on a Caribbean island, the course of prevalent and incident TDt was measured with the Fahn-Marsden rating scale. Of the 26 patients (mean age 53.3 yrs) with TDt at baseline, 64% recovered, 20% persisted, and in 16% the course was intermittent. The severity of baseline TDt was significantly higher in persistent cases versus those who recovered (t=3.01, P<0.008). Of the 27 incident cases (cumulative 9-year incidence: 16.1%; mean age 57.6 yrs), 80% recovered, 8% persisted, and in 12% the course was intermittent. Predominantly affected were hands, eyes (blepharospasm), neck and mouth. The natural course of TDt is better than previously suggested but severe cases tend to persist.
迟发性肌张力障碍（TDt）是长期使用抗精神病药物的一种严重副作用。以往的出版物表明TDt会持续存在，但结果因转诊偏倚而失真。在加勒比海一个岛屿上对慢性精神病患者（N = 194）进行的一项基于人群的九年随访研究（一次基线检查，六次随访）中，使用法恩-马斯登评定量表测量了现患和新发TDt的病程。在基线时患有TDt的26名患者（平均年龄53.3岁）中，64%康复，20%持续存在，16%的病程呈间歇性。持续存在的病例与康复病例相比，基线时TDt的严重程度显著更高（t = 3.01，P < 0.008）。在27例新发病例中（9年累积发病率：16.1%；平均年龄57.6岁），80%康复，8%持续存在，12% 的病程呈间歇性。主要受累部位为手部、眼睛（眼睑痉挛）、颈部和口腔。TDt的自然病程比之前认为的要好，但严重病例往往会持续存在。
